急性淋巴细胞白血病患儿T淋巴细胞免疫功能的研究

目的　研究急性淋巴细胞白血病 ( AL L )患儿初治时和完全缓解 ( CR)后外周血 T淋巴细胞亚群数量及其功能 ,寻找更好的控制儿童白血病的方法。方法　采用单克隆抗体在流式细胞仪上测定了 18例 B淋巴细胞系 AL L 儿童初治时、CR后外周血单个核细胞 ( MNC) CD3、CD4、CD8以及 IL-2受体 ( CD2 5 )含量及其 T淋巴细胞内细胞因子 γ-干扰素 ( IFN-γ)和肿瘤坏死因子 -α( TNF-α)水平。结果　初治时患儿 CD4/ CD8为 ( 1.10± 0 .79) ,较健康儿童 [( 2 .74± 1.2 1) ]明显降低 ( P<0 .0 1) ;CD4、CD8产生细胞因子的能力 ( IFN-γ和 TNF-α水平 )均低于正常儿童 ( P<0 .0 5)。 CR后 ,CD4/ CD8为 ( 2 .54± 1.3 9) ,比初治时明显提高 ( P<0 .0 5) ,CD4、CD8产生细胞因子的能力增强 ,但与正常对照组比较 ,各项数值仍低。初治患儿 CD4T淋巴细胞中 CD2 5 细胞数量为 ( 0 .76± 0 .56) ,明显低于 CR患儿 [( 2 0 .4± 5.1) ]和对照组 [( 16.3± 6.3 ) ] ,P均 <0 .0 1。结论　免疫损害在白血病的发病过程中起重要作用 ;T淋巴细胞的免疫功能与儿童白血病的预后关系密切 ;促进患儿免疫功能的恢复对治疗有重要意义     

老年非小细胞肺癌患者外周血T淋巴细胞活化抗原表达的临床研究

目的　观察老年非小细胞肺癌患者外周血T淋巴细胞活化抗原CD3+ /CD2 5 + 、CD3+ /HLA DR+ 和CD3+ /CD6 9+ 的表达。　方法　应用流式细胞双色免疫荧光标记术对 4 5例老年肺癌患者上述 3种外周血T淋巴细胞活化抗原表达进行检测 ,并与非老年肺癌组、健康老年对照组和老年良性病变组对比。　结果　 4 5例老年肺癌患者外周血T淋巴细胞中CD3+ /CD2 5 + 、CD3+ /HLA DR+ 和CD3+ /CD6 9+ 表达 (分别为 7 2 4± 1 85、2 8 4 6± 5 39和 7 78± 2 6 3)低于健康老年对照组(分别为 10 35± 2 5 4、37 16± 5 5 1、11 0 2± 2 18)和良性病变组 (分别为 9 5 3± 3 0 2、35 33± 5 2 3、10 6 7± 2 4 5 ) ,P <0 0 1。老年组与非老年组表达水平比较差异有显著性 (P <0 0 5或P <0 0 1)。对照组和老年良性病变组之间差异无显著性 (P >0 0 5 )。Ⅲ、Ⅳ期 (分别为 7 15± 1 13、2 5 32±5 2 3、7 14± 2 81)和Ⅰ、Ⅱ期 (分别为 8 0 6± 1 2 1、30 2 7± 6 0 5、8 4 3± 2 6 7)表达比较 ,差异有显著性 (P <0 0 1)。中、高分化程度的肺癌患者其表达 (分别为 8 2 3± 1 2 3、34 0 5± 6 6 1、11 2 5± 3 2 2 )明显高于低分化程度的肺癌 (分别为 7 0 2± 1 35、2 5 31± 5 87、5 31± 3 5 7) ,P <0 0     

肠易激综合征患者外周血T淋巴细胞亚群分析

目的　肠易激综合征 (IBS)的发病机制是否与炎症免疫有关 ,有待于进一步证实。调查IBS患者血中T淋巴细胞计数及其亚群比例 ,旨在探讨IBS发病新机制。方法　对符合罗马Ⅱ诊断标准的 30例IBS患者及 30名健康对照者的外周血淋巴细胞总数用AC 92 0全血细胞分析仪检查分析 ,采用免疫荧光法并用SimulSET自动软件分析方法进行T淋巴细胞亚群检测。结果　患者外周血淋巴细胞的平均值为 (2 .1± 0 .5 )× 10 9/L ,健康对照组为 (2 .2± 0 .6 )× 10 9/L ,两组差异无显著性 (P >0 .0 5 ) ;T淋巴细胞亚群分析 ,IBS患者外周血CD8值明显高于健康对照组 (P <0 .0 5 ) ,CD4值明显低于健康对照组 ,CD4/CD8比值下降 (P <0 .0 5 ) ,CD3 值与健康对照组相比差异无显著性 (P >0 .0 5 )。结论　IBS患者外周血淋巴细胞总数正常 ,但CD8升高 ,CD4下降 ,CD4/CD8比值下降 ,CD3 正常 ,提示腹泻型IBS可能与免疫下降有关     

子宫内膜异位症与T辅助细胞亚群及其细胞因子的关系

目的　探讨T辅助细胞 (Th)亚群中的T辅助细胞 1(Th1)和T辅助细胞 2 (Th2 )所分泌的细胞因子在子宫内膜异位症 (EM )发病中的作用。方法　应用细胞因子体外诱生培养技术对 35例EM患者及 18例健康育龄妇女外周血单个核细胞 (PBMC)加入植物血凝素 (PHA)进行培养诱生 3天 ,收集上清液。采用酶联免疫吸附试验双抗体夹心法 (ELISA)分别测定血浆及PBMC培养上清中Th1类因子干扰素 γ(IFN γ)及Th2类因子白细胞介素 (IL) 4、6、10的含量。结果　EM患者PBMC诱生培养上清中IL 4、IL 6、IL 10水平 [(37 36±13 6 5 )、(6 94 32± 110 93)、(80 39± 2 3 0 2 )ng/L]比对照组 [(2 6 36± 4 32 )、(5 2 6 35± 10 2 34)、(5 9 73±2 0 32 )ng/L]明显升高 ,差异有显著性 (P均 <0 0 1)。EM患者的IFN γ为 (10 87 3± 380 9)ng/L ,与对照组的(16 37 8± 340 8)ng/L比较差异有显著性 (P <0 0 1)。EM患者PBMC诱生培养上清中IFN γ/IL 4为 36 4 7±19 4 1,与对照组的 74 86± 13 4 2比较差异有显著性 (P <0 0 1)。在血浆中 ,除了EM组的IL 4、IL 6水平[(36 2 8± 17 4 6 )、(16 4 6± 5 4 8)ng/L]与对照组 [(2 2 4± 5 2 0 )、(12 32± 3 6 7)ng/L]比较差异有显著性 (P均<0 0 5 )外 ,两组IL 10、IFN      

干细胞移植后合并巨细胞病毒感染时淋巴细胞亚群变化

目的　研究异基因外周血干细胞移植 (PBSCT)后早期巨细胞病毒 (CMV)活动性感染时淋巴细胞亚群变化及其意义 ,探讨活动性CMV感染对免疫的影响。方法　根据CMV感染情况 ,将 2 7例早期PBSCT受者分为症状性感染、无症状活动性感染以及同期未出现活动性感染 3组 ,5 1例正常人作为对照组 ,用流式细胞仪测定其淋巴细胞表面CD3 、CD4、CD8、CD16、CD56、CD19、CD2 8的表达 ,比较各组间的差异。结果　PBSCT后早期CD+ 4 T和B细胞数量显著低于正常人 (P值均 <0 0 1) ;2 7例受者中无活动性CMV感染 5例、无症状活动性CMV感染 10例和症状性CMV感染 12例。上述 3组病人的平均CD+ 4 T细胞计数 (× 10 6/L)分别为 32 8± 2 0 3、2 39± 2 18和 199± 92 ;CD+ 8T细胞计数 (× 10 6/L)分别为 4 0 0± 380、2 6 7± 2 0 6和 6 0 3± 4 6 1;CD+ 4 CD+ 2 8的功能细胞亚群的比例分别为 (89 2± 8 9) %、(84 2±10 1) %和 (6 3 5± 11 4 ) % ;自然杀伤 (NK)细胞比例分别为 (16 2± 11 1) %、(2 9 3± 9 9) %和 (19 2±10 2 ) %。与无活动性CMV感染者相比 ,无症状CMV活动性感染者除NK细胞升高外 (P <0 0 1) ,其他指标差异无显著性 ;而症状性CMV感染者和无症状CMV感染者相比 ,其CD+ 4 T细胞数量显著减少(P <0 0 1) ,CD+ 8T     

支气管肺泡灌洗液T淋巴细胞亚群和细胞DNA含量分析对肺癌的诊断价值

目的　探讨支气管肺泡灌洗液T淋巴细胞亚群和细胞DNA含量分析对肺癌的诊断价值。方法　用流式细胞仪对 3 0例肺癌和 12例肺良性病变患者的支气管肺泡灌洗液 (BALF)作T淋巴细胞亚群和细胞DNA含量分析 ,并与纤维支气管镜活检和刷检比较。结果　中央型肺癌组BALF中CD3 + (11.473± 3 .677) %、CD4+ (3 .660± 1.60 5 ) %、CD8+ (2 .3 49± 0 .880 ) %和CD4+ /CD8+ (1.411± 0 .3 0 9) ,周围型肺癌组BALF中CD3 + (12 .2 73± 4.42 5 ) %、CD4+ (2 .897±0 .695 ) %、CD8+ (2 .2 5 9± 0 .5 91) %和CD4+ /CD8+ (1.3 0 7± 0 .2 45 ) ;肺良性病变组BALFCD3 +(2 5 .0 78± 7.13 8) %、CD4+ (13 .2 44± 4.15 9) %、CD8+ (7.63 1± 3 .713 ) %和CD4+ /CD8+ (2 .2 78±0 .619) ,前两组显著低于后组 (肺良性病变组 ) (P <0 .0 0 1)。以异常二倍体为阳性标准 ,诊断肺癌的敏感性为 83 % ,特异性为 92 % ;中央型肺癌异常二倍体阳性率为 89% ,与活检 (95 % )和刷检(68% )比较 ,差异无显著性 (P >0 .5和P >0 .1) ;周围型肺癌异常二倍体阳性率为 82 % ,显著高于活检 (2 7% )和刷检 (2 7% )阳性率 (P均 <0 .0 5 )。结论　肺癌患者免疫功能低下 ,是肿瘤发生发展的原因之一 ,支气管肺泡灌洗液细胞DNA含量分析是诊断肺癌 (尤     

小剂量茶碱调节哮喘患者T淋巴细胞的活性

目的 :观察茶碱对哮喘患者血清T淋巴细胞活性影响。方法 :检测哮喘患者每d给予茶碱控释片 4 0 0mg治疗 6周前后血清可溶性白细胞介素 2受体 (sIL 2R)浓度、T淋巴细胞亚群和IgE水平变化。结果 :哮喘患者经茶碱治疗 6周后其血清sIL 2R浓度显著下降 ,从治疗前 ( 0 31± 0 10 )U/L ,降低到治疗后 ( 0 2 5± 0 0 6 )U/L ,P <0 0 5。茶碱能显著提高哮喘患者外周血中的CD8T淋巴细胞数 (从治疗前的 18 9%± 4 4 %提高到治疗后的 2 5 8%± 5 9% ,P <0 0 5 ) ,同时CD4 /CD8%相应地显著降低 (P <0 0 5 )。茶碱并有降低哮喘患者外周血中IgE水平的趋势。结论 :小剂量茶碱能抑制哮喘患者血清T淋巴细胞活性 ,不仅具有抗炎作用 ,还有免疫调节作用 ,为评价茶碱在哮喘治疗中的作用提供了依据。     

雷公藤多甙对(口恶)唑酮诱导小鼠肠炎模型脾淋巴细胞因子的作用及其机制

目的　观察小鼠肠炎模型体外实验中 ,雷公藤多甙 (MGT)对唑酮 (oxazolone,OXZ)诱导的小鼠肠炎模型中脾脏淋巴细胞细胞因子分泌类型的影响 ,从免疫学、分子生物学角度探讨MGT治疗炎症性肠病 (IBD)的作用机制。方法　采用SJL/J小鼠 ,经直肠注入OXZ制成IBD模型 ;3d后将小鼠处死 ,即刻取出脾脏 ,收集脾细胞 ,将MGT(0 .1和 0 .0 1mg/ml两个浓度 )分别加入培养的淋巴细胞液中 ,行ELISA检测白介素 4 (IL 4 )和γ 干扰素 (IFN γ)。结果　 1.MGT对IFN γ生成的影响 :(1)正常对照组 :未加入MGT组 (空白对照 )的IFN γ为 (1.2 4± 0 .13) pg/ml;0 .0 1mgMGT组为(0 .97± 0 .2 6 )pg/ml;0 .1mgMGT组为 (0 .87± 0 .18) pg/ml;(P <0 .0 2 ) ;(2 )OXZ肠炎模型组 :与正常对照组比较 ,未加入MGT组 (空白对照 )IFN γ显著降低 [(0 .6 5± 0 .0 8) pg/ml比 (1.2 4±0 .13) pg/ml,P <0 .0 1],0 .0 1mgMGT组和 0 .1mgMGT组IFN γ均低于空白对照 [分别为 (0 .4 7± 0 .0 5 ) pg/ml;(0 .4 6± 0 .0 9) pg/ml],但差异无显著性。 2 .MGT对IL 4生成的影响 :(1)正常对照组 :未加入MGT组 (空白对照 )的IL 4为 (5 .6 5± 0 .4 8) pg/ml;MGT有显著抑制作用 [0 .0 1mg/mlMGT组为(4.97± 0 .38) pg/ml;0 .1mgMGT组为 (3.98± 0 .32     

CCR9在T淋巴细胞白血病CD4+T细胞上表达的变化及临床意义

目的探讨淋巴细胞白血病(TLL)CD4+T细胞上CCR9表达的变化及临床意义.方法选择38例TLL患者[T-急性淋巴细胞白血病(ALL)21例,T-慢性淋巴细胞白血病(CLL)17例],对照组18例.用免疫磁珠分选出各组CD4+T细胞,以流式细胞仪分别测定CCR9在T-ALL和T-CLL CD4+T细胞上的表达及在对照组CD4+T细胞上的表达,各组间进行对比分析.结果CCR9表达在T-ALL与T-CLL患者CD4+T细胞比较[(73±17)%(35±18)%,P＜0.01],与对照组(2.0±1.0)%比较差异有统计学意义(P＜0.01).结论TLL患者CD4+T细胞存在CCR9高表达,CCR9检测可能作为其诊断和疗效观察指标之一.     

93例传染性非典型肺炎患者外周血T淋巴细胞亚群变化及临床意义

目的　了解传染性非典型肺炎 (世界卫生组织又称严重急性呼吸综合征 ,SARS)患者外周血T淋巴细胞亚群的变化。方法　采用流式细胞仪对 93例临床确诊的SARS患者、5 0例获得性免疫缺陷综合征 (AIDS)患者及 6 4例健康体检者外周血T淋巴细胞亚群进行检测。 93例患者中 ,男4 0例、女 5 3例 ;年龄 17～ 88岁 ,平均 4 4岁 ;重型 35例、普通型 5 8例。结果　健康体检者外周血CD+ 3 、CD+ 4 、CD+ 8分别为 (15 2 7± 4 70 )、(787± 2 5 7)、(6 33± 2 80 )个 / μl;93例急性期SARS患者分别为(72 2± 5 33)、(438± 35 3)、(30 7± 2 17)个 / μl,均有不同程度的下降 (P值均 <0 .0 1) ,重症病例下降尤其明显 ,5例死亡患者外周血CD+ 4 均低于 2 0 0个 / μl;SARS患者恢复期CD+ 3 、CD+ 4 、CD+ 8多数恢复正常。而AIDS患者以CD+ 4 降低为主 ,为 (2 96± 2 98)个 / μl;且CD+ 8升高 ,为 (818± 5 6 6 )个 / μl。 结论SARS患者有明显的细胞免疫损伤。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.